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High-Sensitive Cardiac Troponin (hs-cTn) is an indispensable diagnostic tool in detecting myocardial injury. Measurement of Hs-cTnT facilitates early decision-making and treatment in patients suspected with acute coronary syndrome.
This is a retrospective, single center study including all patients whom Hs-cTnT was taken to rule out Acute Coronary Syndrome (ACS) in Hospital Sungai Buloh from 18/11/2015 until 31/12/2015.
A total of 846 patients were identified. 523 (61.8%) were male while 323 (38.2%) were female. The Malays comprised of 553 (65.4%) followed by the Indians with 145 (17.1%), Chinese with 113 (13.4%) and the rest at 34 (4%). The mean age of the patients was 52 ± 16 years old.
The median value for Hs-cTnT was 11.45 (IQR 32) ng/L.
When significant Hs-cTnT level was taken as of more than 34.2 ng/L, 54.2% of the male patients were correctly diagnosed as having a myocardial injury. Whereas for the female, with Hs-cTnT of more than 15.6 ng/L, the diagnosis of myocardial injury was correctly made in 25.5% of the patients.
Based on ROC curve we noticed that lower hs-cTnT level of 26.55 ng/L for male and 6.75 ng/L for female were needed for the best 95% sensitivity of detecting myocardial injury in our population with a 50% negative predictive value.
We proposed that the Hs-cTnT level has to be adapted based on our local evidence in order to achieved better diagnostic and treatment accuracy. Larger multi-center studies are needed to reach to the point.